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Treating chronic pain

In Australia, 1 in 5 people live with chronic pain. As well as physical pain, it can cause high levels of psychological distress and disruption to your life. Here’s how to tackle it.

Health AgendaOctober 2018

For many of us, pain is an uncomfortable but thankfully temporary experience. It has a clear cause, like an injury or illness, and medication generally provides relief. When you’ve healed or recovered the pain goes away.

This acute, short-term pain is your body signaling that something is wrong, prompting you to take action (such as resting) to prevent further injury or aid recovery.

But for people who are living with chronic pain, it’s not that simple.

What is chronic pain?

Chronic pain is defined as pain that lasts beyond the time expected for healing; typically longer than 3 months. This could include pain in the back, neck, limbs, joints or head. Chronic pain can be triggered by surgery, injury or a health condition. Frustratingly, for some there isn’t an obvious cause.

“[In this case] the pain is less to do with an injury to body tissue and more to do with what’s happening in your nervous system,” says Painaustralia CEO Carol Bennett. “Your nervous system can become sensitised and overactive, so you continue to feel pain, even without ongoing tissue damage.”

“It’s a condition itself, [even if] it’s not necessarily linked to something, such as arthritis,” she says.

Pain on the brain

The big question is why some people develop chronic pain, even after an injury or health problem has long gone.

“The way your brain processes pain can become fixed, so it becomes hyper-vigilant to any type of behaviour or movement that’s perceived as threatening to that area of your body,” says University of New South Wales Associate Professor James McAuley, psychologist, and a spokesperson for Neuroscience Research Australia.

“When you have some sort of threat to your body, such as a movement, which in the past may have been difficult or painful … it sends a barrage of signals up your spinal cord into your brain,” he says.

“If that [communication] is that there’s a threat to your body, your brain wants to protect you from that threat, so you’ll receive a message of pain. You’ll then stop doing what you’re doing, to avoid potential damage to your body.”

Treatment options

An integrated approach, including medication and other therapies, may be beneficial. Your GP can refer you to local health services and other health professionals, including a pain clinic, psychologist or physiotherapist, to develop a solution that works best for you.

Medication, such as over-the-counter or prescription painkillers, may be effective in some cases. However, it’s important to consider the risks and benefits of short and longer-term use with your doctor. An (appropriate) level of physical activity is also a good idea.

Chronic pain can bring up a range of emotions, including anxiety, depression, frustration and anger. These feelings may be triggered by dealing with the pain itself, or the effect it can have on your life, like missing work or social events. Other people being dismissive of an ongoing but invisible condition could also be a source of distress.

Mental health professionals can help you work through these emotions and provide coping strategies. They may also be able to give you tools to change the way you perceive your pain, which can actually affect the level of pain you experience.

“CBT can be very effective in helping a person learn to deal with the anxiety that’s causing or triggering a type of pain,” says Bennett. “Sometimes, psychology is an important part of the mix to help somebody.”

The mind-body approach

The mind-body connection is the focus of the Freedom From Chronic Pain treatment program. Part of the 2018 HCF Catalyst program, Freedom From Chronic Pain developed its approach in response to new research on mind-body pain treatment which showed promising results. The aim is to change neural pathways in the brain with a therapist supported online program which works with emotions, beliefs and behaviours.

“From clinical experience, we’ve observed that most people with chronic pain can eliminate or significantly reduce pain using a mind-body approach”, say co-founders Hal Greenham and Dr Howard Schubiner.

“The key is how to change the brain, and our mission is to empower people with the knowledge and support they need to do that.”

Self-care advice

Painaustralia recommends the following strategies for those suffering from chronic pain:

Try to accept the pain. It may not disappear, but recognise that you can do things to minimise its impact on your life and reduce its severity.

Change the way you think about pain. Understanding that pain in itself isn’t harmful and learning to not react to it in a negative way can help lessen its effect on you.

Maintaining a healthy weight can improve symptoms of chronic pain, particularly for people with osteoarthritis and other musculoskeletal or joint pain.

Freedom from Chronic Pain are currently beta testing their online recovery program based on mind-body principles. HCF members are eligible for a discount on the program in exchange for providing feedback on their experience. Learn more about the offer

THE POWER OF BRAIN TRAINING

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